Posted by DianeD on May 24, 2001, at 13:24:17
In reply to Re: Methadone - AndrewB and all interested, posted by H. Vincent MacGruder on May 7, 2001, at 9:32:55
Replies and additions
> >Elizabeth > We're talking about using it as an AD -- not for pain or opioid dependence.
> > Elizabeth > You can't assume that the principles that apply to MMT will also be true of the use of methadone (or other opioid agonists) for depression.
I don't see why not. After so many days/weeks my system is clean of heroin so I don't see where I would then differ from a straight AD patient or anyone else.
If you are talking about starting dosage than yes maybe/probably so. But like I said before, clinics start you out on 40mg whether you are a light weight or heavy weight user.
I've gone in as both. The former (light weight) is when Methadone worked it's miracle on me.
I don't know of any studies, clinical trial, with Methadone in regards to depression, except for the ones sighted below and the one I found by Goldstein, J.A. "Methadone for depression."
Biol. Psychiatry 19(8): 1272-73, 1984. , which is all of three tiny paragraphs. I'll add it to the end of this post*
All I know is my own personal experience with it . I've said it before and I'll say it again, I had no expectation from Methadone except to keep me from getting sick. The
AD effect was a total surprise. And it was 100%. 180 degree turn 'round, complete remission, whatever you want to call it. That was with 40mg. The only reason I
eventually went up to 80mg was because I was scared to death the AD effect would disappear if I didn't (the old tolerance mentality). I mean this was the first time in my
life I'd ever felt/been NORMAL. First time ever!, my first taste, and I was scared to death of loosing it. I was Euthymic.
> >Elizabeth >That depends on your reaction to it (highly individualized). Some people feel "foggy" on it.
I am not suggesting by any stretch that Methadone is right for everyone or that it will have the same effect. But I figure if it worked miracles for me that it just might work for others.
Water is probably the only thing one could safely say is right for everyone.
> > DianeD > methadone does not get you high
I knew I should of clarified that. Here goes. When people think of Methadone they immediately think that because it's used as a heroin "substitute", that it must behave the same as they
envision heroin. And most peoples knowledge of heroin comes from Hollywood. Which means, they see a gutter junkie stumbling around unable to keep his eyes open and speaking in a
slurry mess. What you are seeing is either a person who is in the middle of a heroin rush, which last maybe an hour or so depending of course on numerous factors. or one who has just
consumed way too much. Anyway, I don't want to think about that crap cuz I think it's gross too. Well Methadone doesn't work like that. GRANTED if you took some god awful
amount or were injecting it I'm sure it would. But we are not talking extremes here.....or at least I'm not. I'm talking responsible individualized dosing here.
"A single dose administered to stabilize an individual lasts between 24 - 36 hours without causing euphoria sedation or analgesia. This enables the individual to function normally and to
perform mental and physical tasks without impairment. "
" In proper doses, methadone does not create euphoria, sedation or analgesia. It does not harm motor skills, mental capability or employability."
For me, 20 mins. after dosing I might feel it coming on for all of one minute, BUT, that is IF and only if, I happen to be sitting waiting at a stop light. Otherwise I didn't. Like I keep saying
it isn't that type of drug. The delivery is long and slooooow. Unlike other opiates which can slap you upside the head.
> >NikkiT2 > Oh, and so if Effexor is as bad as Metadone, why is Methadone sold on the "black amrket", yet effexor isn't??
Because Effexor is readily available/obtainable to one and all. Methadone is not. Every time you "outlaw" something a black market develops. That's why the "War on
Drugs" is a failure. Prohibition was a failure.
Re: Fears of methadone diversion (your black market). Yes, there are people who sell their doses of methadone but they are very very VERY few.
And there are even fewer buyers cuz it's sold at such ridiculously high prices. A dollar a milligram in 1992 (who knows what it is today) The normal/average dose of methadone
is 80 mg a day. Do the numbers. It'd cost you $560.00 per _week!
"While methadone has some potential for abuse when diverted from normal channels, the extent of the abuse associated with diverted methadone is small relative to heroin and cocaine,"
reports a 1995 Institute of Medicine report on methadone. Dr. Lewis Judd, psychiatric department chair at the University of California at San Diego and chair of a National Institutes of
Health panel that examined methadone's utility, describes the black market for methadone as a "negligible" problem. Most of those who take diverted methadone are seeking to stabilize
themselves before entering treatment, or want to quit but aren't yet ready to seek help, he says. Most experts agree that methadone rarely is a preferred drug for illicit drug users because
its action is too slow and the level of euphoria it provides is too mild."
Alcohol is toxic/addictive, has high abuse potential yet is legal. Cigarettes are toxic/addictive, have high abuse potential yet are legal. Methadone is non-toxic/ is addictive and has low
abuse potential but it is outlawed to the point were doctors fear prescribing it. It is villainized.
"Methadone has no active metabolites. Much of the toxicity associated with other opioids (e.g., morphine, hydromorphone, meperidine, and fentanyl) is the result of metabolite
"Concerns about methadone's effects on the immune system and on the kidneys, liver and heart have been laid to rest. Methadone's most common side effects - constipation and sweating
- usually fade with time, and are not serious health hazards."
"Methadone is well tolerated long term with no appreciable side effects other than physical dependence." J.A Goldstein.
Methadone has been around for what, 50+ years? Death and/or illness from Methadone is rare.
> >NikkiT2 > Cos Effexor doesn't give you a high...
Depends on what you consider a high. If it relieves you of your depression you might very well feel high......good. You definitely ain't feeling LOW. For me feeling normal for
once was the best high I'd ever had.
Like I said before methadone is like a runners high. I can't compare it with other opiates cuz I never cared for other opiates. Heroin is garbage compared to Methadone. Heroin
is just a pacifier. Methadone gave me energy, stability, strength. Rid me of my anxiety therefore I could listen and learn and remember under stress. It put me on an equal
footing with everyone else. Gave me a positive, I-can-do-to-it, force. And on and on......
Somebody here said something about a friend of theirs having to go into the clinic everyday.
That is incorrect or rather that is not the norm.
After 2 or 3 months, if you are clean/drug free, you get your first take-home. Usually within 6 to 8 months of your admittance you have five take-homes. So you only come
into the clinic twice a week. If you are dirty tho, you're not given take-homes or your take-homes are taken away from you as punishment. Take-homes are "earned"
> >Elizabeth >. I don't believe there are "good drugs" and "bad drugs" (except for a few
things which are simply toxins). I believe there are helpful uses and unhelpful or harmful
uses of almost all drugs.
I agree 100%. Elizabeth is able to put this subject in better perspective. It's too much of an emotional issue for me. It angers me that I can't get the one thing that works for me.
And that makes me feel more helpless than I already am. Suicidal. I've tried asking my doctor to help me. No go. I have asked at various boards. Got one guy who gets it indirectly for
depression. He has become a serious methadone advocate as a result of his experience. And is in fact co-director of ARM Home Page - Advocates for Recovery through Medicine
(http://www.arm-advocates.org/). He was never a heroin/opiate user. Here is some of what he wrote to me. "Fortunately for me Diane, America is a Capitalistic society. In other words, if
you got money you can get what you want---away with murder even, I'm afraid (he's referring to O.J, that's how long ago this was) I had "friends" and a valid reason to get dolophine,
even though my doctor knew it was for depression. He and I were the ones that went and found that research you read on Rose Whithers website-and he prescribed me dolophine
(methadone) for depression."
Here's Rose Whithers website and the index page of "Medical Articles about opioids and their use as a treatment of Depression, Bipolar Disorder and other psychiatric
> >Cecilia > I`m quite certain my HMO would never approve of opiates for depression-there`s no way I would even ask.
I'm quite sure they wouldn't either and I find that a real shame. Even mentioning it would probably send up warning flags and brand you as a possible drug seeker. The doc might even put
a six-sided star * in your file.
Yep. I was totally up front and honest with my doctor (something I will never do again) but it's obvious now that he didn't believed me. I even told him I had hepatitis three times and was
interested in getting vaccinated against Hep. B. But it wasn't until five years later and for reasons unknown, he decided to run a liver function test. The results of which he never bothered
to inform me until I just happened to make an appointment to ask for a Wellbutrin scrip. ONE YEAR and 27 days later. Turns out I had had Hep B. and currently had/have
Hep. C. Could I sue for malpractice over that? It's all in my file. I handed him a printout of my history the very first day I went to him in '95, and have handed him a printout of
symptoms, question etc. every time I've seen him.
Anyway, after that, I think he finally believed me about heroin/methadone, cuz he now treats me like I'm the scum of the earth. I kid you not. It's like night and day. It's amazing the
prejudice and out and out hate surrounding heroin/Methadone. Even tho I've been clean of heroin for 17 yrs, and methadone 9 yrs. Elizabeth's "negative knee-jerk
reaction" says it all. People's minds just clamp shut.
I read somewhere on a website dedicated to statistics, that 80% of the people who abuse/use heroin were from the middle and upper socio-economic class brackets. That
only 20% came from the lower to poverty levels. And I can believe it. My husband and I were middle class and most the heroin users we knew were also.
> > Elizabeth > Methadone is a controlled substance because it is considered (rightly) to have *abuse potential* -- *not* because it is considered "addictive."
In my mind, everything has abuse potential and can be addictive. Methadone has the least abuse potential of all the pain killers. See above.
> >NikkT2 > *g* I personally luuuurve diazapam.. its one of the few meds that have ever helped me ... but I won't take them due to their addiction level,
Oh the sacrifices we make. Gee, isn't it nice that NikkT2 has the option/choice of getting Valium, which she dearly loves, but suffers to not partake. Her forbidden fruit.
And how nice to be able to fly off to Thailand for a little backpacking. Must do your depression/anxiety good. It's a totally different ball game when you have the power of
choice (and money don't hurt either).
I use to do allot a backpacking (CA,OR) till a black bear wrenched my brand new big Kelty from between two trees (30' up mind
you) and ripped it to shreds. Ate all the food, packaging and all! Don't you know, some people just have all the luck ;o) I apologize in advance Dr. Bob.
Can a psychiatrist prescribe methadone? Can a psychiatrist prescribe methadone for pain?
LINKS OF POSSIBLE INTEREST (I should of search for more but I've got a raging headache now. I'm sorry, maybe next time 'round)
http://www.amazon.com/exec/obidos/ASIN/0767900316/drbobsvirte00-20 Excellent book on how it is and how the War on Drugs is failing. This
comes from the same guy who wrote "Homicide" (from whence the TV series came) another excellent non-fiction book.
Methadone for Depression Jay A. Goldstein January 25, 1984
I read with interest the article in the September 1983 issue "Methadone, Monomine Oxidase, and depression: Opioid Distribution and Acute Effects on Enzymes
Activity", by Kaufmann er al.
The authors were unable to account for the antidepressant effect of methadone by monoamine oxidase inhibition. A paper has been published showing that methadone displaces
3H-impramine from it's binding sites in rat brains and platelets with a IC50 at least 100 times less
than morphine or met-enkephalin (De Montis et al. 1982). The authors suggested that the antidepressant effect of methadone was probably independent of it's opioid activity for this
I have prescribes methadone or suicidal patients with severe cardiopulmonary disease when their cardiologist were apprehensive about using traditional antidepressant agents (Goldstein,
1981). I have found that very low doses were effective in this elderly population, usually
about 5mg daily. One woman became hypomanic on this dose but did well on 5mg every other day. Tolerance did not develop, and one patient was maintained on methadone for 3 years,
since she became depressed again when it was stopped. No side effects were apparent.
Several researchers have used methadone as an opioid agonist when assessing neuroendocrine relationships in various diagnostic groups. Since methadone appears to have intrinsic
antidepressant properties, results in studies such as these should be skeptically viewed if certain
skewing of results toward the affective disease category is demonstrated.
De Montis, G. M., Devoto, P., and Tagliamonte, A. (1982). Possible antidepressant activity of methadone. Eur. J. of Pharmacol. 79: 145-146.
Goldstein, J. A. (1981, September 23). Therapeutic lessons from a family practitioner. Terapaeia, 24-23.
Kaufmann, C.A., Kreek, M., Raghunath, J., and Arns, P. (1983). Methadone Monoamine oxidase, and depression: Opioid distribution and acute effects on enzyme activity. Biol.
Psychiat. 18" 1007-10021.
I've written everybody from the President of the US on down the line thru the House, Senate, DEA, FDA, Boarderpatrol, local and non-local Newspapers editorials, you name it I've
written to em to share my experience and express thoughts on the issue of Methadone. I write my own congressmen regularly and send my own personal form letter quarterly to every
member of the Senate, House of Rep.
I want my Methadone. I don't want to have to lie to a doctor to get it. The rules governing methadone prescribing are archaic. They are not based on currant knowledge but on old
unfounded fears. More damage has been done in this world because of fear than probably anything else. Fear and ignorance go hand and hand. They feed off each other.
Which reminds me, I just finished reading Steven Kings latest offering "Dreamcatcher". It stinks. It is his worse yet. It is the worse book I've ever read in my whole life in fact. I don't
recommend it :o)